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A 10 percent cut in state Medicaid funding will cost nursing homes in Kansas’ 70th District $1 million in 2010, Rep. Bob Brookens said Sunday at a community meeting in Goessel. The majority of that loss will be in Marion County.

Medicaid is funded by a combination of state and federal money. In Kansas, 30 percent of the funding comes from the state and 70 percent from federal, Bethesda Home CEO Linda Peters said Sunday. For every dollar by which Kansas reduces Medicaid spending, care providers lose $2.31 of federal money.

Of Bethesda Home’s residents, 65 percent are paid via Medicaid. Peters expects the state Medicaid reduction will cost the facility about $158,000. Administrators and staff have attempted to minimize the effect the cut has on resident care.

Among the measures Bethesda home has taken to cut costs are reducing employee benefits, voluntary wage cuts, monitoring energy consumption, and ending contracted services such as outside laundry service.

If the cuts remain, the facility may have to take more measures, including reducing staff, freezing wages, increasing private pay rates, or limiting Medicaid admissions.

“How much can you cut before people start to suffer?” Peters said.

Other nursing homes are struggling to stretch revenue without reducing care quality, as well.

Salem Home in Hillsboro expects to lose about $10,000 per month of Medicaid funding, Administrator Kelly Schlehuber said. The facility has 57 percent Medicaid residents. The Kansas average is 56 percent.

The state reduction was announced about two weeks before it went into effect Jan. 1, Schlehuber said. That made it difficult for the facility to reduce costs before the cut took effect.

Salem Home cut two full-time positions, department heads took a 10 percent pay cut, reimbursement for education and travel were eliminated, supervisor hours were reduced 10 percent, and all staff parties were eliminated, Schlehuber said.

If state cuts increase, another three positions may be cut, she said. Administrators are trying to keep up morale among employees, because nursing home care doesn’t get easier with funding cuts, she said.

Some state legislators have focused on schools and Medicaid to eliminate budget deficits, Schlehuber said. That effectively targets people least able to protect themselves — children and elderly.

“That really upsets me,” she said.

Westview Manor in Peabody faces a special challenge because of its mental health services, Administrator Bonita Robertson-Boydston said. All of the facility’s 52 residents receive Medicaid.

Because of the state reduction, the facility must reduce expenses by about $9,000 per month, she said. So far no staff cuts have been made, but everything has been evaluated.

St. Luke Living Center of Marion — with 58 percent of residents on Medicaid — has reduced workers’ hours some, but no layoffs have been made, Director of Aging Services Janet Herzet said. She projects a loss of about $76,000 of aid in 2010.

With the reduction in Medicaid funding, nursing home administrators have to be conscious of finances with every decision, Herzet said.

Legacy Park in Peabody had to set aside planned building upgrades because of the Medicaid cut, accounting for a loss of about $15,000 per month for the facility.

About 65 percent of Legacy Park’s expenses are for personnel, Administrator David Scott said. The nursing home is planning to reduce support staff.

Legacy Park has about 71 percent of residents on Medicaid. Despite the cuts, there will be no fundamental changes to the way the nursing home cares for its residents, he said.

“But this complicates the work we do,” Scott said.

Marion Assisted Living has not had any Medicaid residents since the cuts went into effect, Director Jennifer Gaines said. The facility is considered in-home care rather than long-term nursing for Medicaid purposes, she said.

Parkside Homes of Hillsboro was contacted but did not respond in time for this story.